Silicosarcoidosis: Histologic and Clinical Features of an Occupational Granulomatous Disease

作者：Jeremy T. Hua, Carlyne D. Cool, Einat Fireman Klein, Yochai Adir, Lukas Jyuhn‐Hsiarn Lee, L. Zell-Baran, Robert A. Cohen, Richard C. Kraus, E. Brigitte Gottschall, S.D. Krefft, Charles Van Hook, Cecile S. Rose · 发表于：American Journal of Industrial Medicine · 年份：2025 · DOI：10.1002/ajim.23724 · 被引用次数：11 · 研究领域：Sarcoidosis and Beryllium Toxicity Research、Occupational and environmental lung diseases、Occupational exposure and asthma

ABSTRACT Sarcoidosis is a multisystem inflammatory disease of unknown etiology. Growing evidence indicates that occupational exposure to respirable crystalline silica (RCS) is associated with an increased incidence of sarcoidosis. Yet a diagnosis of sarcoidosis rarely prompts investigation to identify preventable exposures. We sought to elucidate features that identify this important clinical syndrome of silicosarcoidosis. We assembled a multinational case series of workers with sarcoidosis who also reported occupational RCS exposure. We characterized clinical and histopathologic findings using a standardized instrument. We also assessed lung specimens using a novel quantitative microscopy technique to measure birefringent dust density in silicosarcoidosis cases and compared them to control groups. We identified 35 silicosarcoidosis cases (97% male, mean age 48 years) from the United States, Israel, and Taiwan who reported 21 ± 9 years of RCS exposure. On histology scoring, 25/29 (86%) had granulomas and 17/18 (94%) with evaluable lung tissue had lymphocytic inflammation and/or lymphoid aggregates. Common lung interstitial findings included silicotic nodules (39%), mixed‐dust macules/nodules (44%), and birefringent dust (50%). Quantitative birefringent dust density was significantly greater ( p < 0.001) in silicosarcoidosis cases compared with healthy controls (147 ± 179 vs. 12 ± 9 particles/mm 2 ) but lower than in coal miners with silica‐related progressive massive fibro...